Doing
Infinite Health as Vegetarian
Edition: 2024-09-12
fruitarian lacto-vegetarian ovo-lacto
ovo-vegetarian pescetarian Undoctored
vegan vegetarian Wheat,Belly
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⟲ About This Page
This article is principally a target to link to when this
question arises on the Dr. Davis Infinite Health Blog,
and the Inner Circle forum.
This is not the official position of Dr. Davis.
There is a 2024 blog post on the topic:
IHB: Are vegan/vegetarian diets
safe? (on PCM, on Blog)
Chapter numbers are provided for eBook editions. The Undoctored
official position is found starting on
page 134 (Chapter 7) of
Undoctored, inset: NO
BOLOGNA: DEFICIENCIES OF VEGANISM AND VEGETARIANISM
(the later
WB R&E and
Super Gut books did not contain this
focused summary).
The present article presumes that someone has already decided to
adopt the Infinite Health (Undoctored, Wheat Belly)
way of enlightened ancestral nutrition (the program), and is
wondering if that can be done and remain vegetarian.
⟲
TL;DR; Yes,
it is possible to do Vegetarian or Vegan
(and variations thereof),
but there are challenges that are almost certainly
going to result in {additional} supplements.
Some of these challenges are shared by anyone remediating
a modern settler diet. But many are inherent to,
or exacerbated by vegetarian diets:
Diet Style |
Relative Effort |
Infinite Health
Super Gut
Undoctored
Wheat Belly |
Standard effort |
Pescetarian
Ovo-lacto vegetarian |
No real extra effort |
Lacto-vegetarian
Ovo-vegetarian |
Mild extra effort |
Stricter vegetarian |
Modest extra effort |
Vegan |
Thought-provoking extra effort |
Fruitarian |
Impossible |
⟲ Ad Hominems
Personally, I tried vegetarian the 1970s, promptly
became anemic, and abandoned it. Dr. Davis has remarked several
times (this from a 2012 WB Blog Comment):
“I don’t pick on the message of people like
Dr. Esselstyn, Ornish, etc., as they are fighting the same battle
as we are: Trying to best understand how to use diet effectively. If
there are enemies, it is Big Food, Agribusiness, and Big Pharma, not
these people.
However, there are a long list of reasons why
the approach advocated by these people, I believe, is dead wrong,
including the Ornish diet made me develop diabetes around 23 years
ago. I am no longer diabetic having done the opposite of what
Dr. Ornish advocated.’
We both understand that there are multiple reasons why people choose
a vegetarian lifestyle (⇩see bottom of article),
and that some postures aren’t negotiable.
⟲ Introduction
The consequences, alas, aren’t negotiable either,
if the nutrients below aren’t all attended to.
Vegetarians need to address the
deficiencies, ⇩change
their minds, or accept the hazards.
It is difficult to find neutral information
on this topic. Anyone providing cautions on being vegetarian
(as I am doing here)
has usually concluded that it’s not an ancestral human diet
for most genotypes. Those advocating vegetarianism may be
dismissive of the hazards, or unrealistic about easier work-arounds.
Homework is required, multiple viewpoints being considered.
Get tested.
Vegetarianism also seems to be a very emotional issue (for
vegetarians). This cannot all be put down to zealotry.
It may well be due to a number of substantial
neurological
hazards
associated with the deficiencies listed below, underlined
for emphasis. They can actually ⎆interfere
with making rational choices on all of this.
Ex-vegetarians, some of whom have written
books about the experience, may also be emotional, for other reasons.
Meat eaters tend to be more sanguine about the whole issue.
⟲ Common Deficiencies
The following macro and micronutrients are commonly too low,
or entirely absent in vegetarian diets (and the flip side of that is
that by default, vegetarian diets tend to be either too high in net
carbs, or too high in adverse fats, not topics here).
I have listed the potential deficiencies in
alphabetical order. A priority order isn’t really possible, because
they are all “essential” - humans need them, and can’t
synthesize them in sufficient amounts
(or in some cases, at all) from precursor foods.
In some cases (e.g. Vitamin A) the synthesis problem is genetic.
Any vegetarian who has not specifically supplemented for these,
and has not been tested, needs to assume they are deficient.
⟲ Amino Acids
Four essential amino acids not provided by most plant foods are
lysine, methionine, phenylalanine and tryptophan. Deficiency hazards
are legion, including growth and energy (lysine),
mood (methionine),
brain function (phenylalanine)
and mood/sleep (tryptophan).
There are any number of resources that describe which
plants provide what, but the list of single plants that
provide all, and meet program nutritional
guidelines, may be empty.
So some combination of various food sources is required,
and typical vegetarian sources lists are loaded with things to avoid
for other reasons, such as quinoa (carb exposure), soy (multiple issues)
and wheat germ (!).[⇱ Return to Nutrients List]
Although osteoporosis is the commonly assumed hazard,
hypocalcemia can result in
neuromuscular
problems (including
adverse heart rhythms) and
seizures.
Many vegetables provide calcium, but may also contain
anti-nutrients that block absorption, so the issue
is one of bioavailability. Nonetheless, eating a lot of spinach
or kale may be safer than taking typical calcium supplements,
which themselves are poorly
absorbed, and often end up everywhere except bones.
If someone insists on supplementing, the hydroxyapatite form
is worth a look. For bone health in particular, also attend to
Vitamins D, K1 and K2 (Undoctored page 136, Chapter 7).
The consensus RDA
for Ca may be too high.
[⇱ Return to Nutrients List]
A
vegetarian (especially vegan) diet is deficient in adequate carnosine,
compared to levels found in a standard diet.
Deficiency is thought to accelerate aging and degenerative diseases,
including
neuromuscular and
Alzheimer’s.
Vegan L-Carnosine (B-alanyl-L-histidine) supplements are available.
[⇱ Return to Nutrients List]
⟲
Choline
The hazards of deficiency include
fatty liver, liver disease, muscle damage,
fetal neural tube defects and possible
neurological
problems.
Choline is not considered "essential" unless methionine and folate are also absent.
This one might be the easiest to address.
Cauliflower, broccoli, brewer’s yeast, spinach and tofu are satisfactory
vegetarian sources of choline.
⎆Denise
Minger identifies some genetic issues that can
exacerbate the risks of choline deficiencies.
[⇱ Return to Nutrients List]
⟲
Collagen
🅑“We
now have human clinical evidence showing us
that collagen ingestion improves skin health,
improves joint health, reduces blood pressure,
reduces insulin resistance and blood sugar,
increases lean muscle mass, and increases bone
density. Add it all up: collagen is an
anti-aging protein.”
🅐“And,
of course, if you are vegetarian or vegan,
your lifestyle is hopelessly lacking in collagen.”
There are no specific lab tests for collagen
deficiency. Various web resources list the
presentations that suggest it, including but
not limited to: skin rashes that may be itchy,
painful, localized, or widespread; fatigue,
weakness & muscle aches; joint pain; fever,
dry skin, eyes or mouth; mouth ulcers; open
sores; sensitive scalp; hair loss, thick &
hardened skin; burning, itching, or blistering
of the skin; numb or cold extremities
(Raynaud’s disease).
Pescetarians might rely on marine collagen.
[⇱ Return to Nutrients List]
This quinone is essential for mitochondrial and cardiovascular
health. We can synthesize it, but often in insufficient amounts
(esp. if a statin is being used). A vegetarian grain-free diet
raises the deficiency risk.
Deficiency risks include: generalized weakness/fatigue,
difficulty concentrating,
mood/depression,
memory lapses.
The complete list is a bit too long for this summary.
Vegetable sources of CoQ10, that are considered “unlimited”
on the program include spinach, broccoli, and cauliflower.
Legumes are also a source, but are considered “limited”.
CoQ10 supplementation is straightforward and needs
to be considered.[⇱ Return to Nutrients List]
This is also not considered strictly "essential", but total
creatine is usually significantly lower in vegetarians.
The hazards of deficiency include impaired muscle mass/performance and
⎆impaired thinking.
Vegetarian creatine supplements are available, but there
is debate on whether this is entirely risk-free.
[⇱ Return to Nutrients List]
HA is becoming increasingly recognized in the program as yet another
modern deficiency, due to declines in consumption of organ meats,
especially brain, kidney, heart, intestines, and skin.
No plant sources provide HA. Vegan supplements made by fermentation
are available.
[⇱ Return to Nutrients List]
Iodine deficiency is a significant cause of 🅠hypothyroidism, and
results in a long and varied list of problems. This deficiency is a
problem for pretty much all modern humans, unless they are on a
diet heavy in seafood. Vegetarians are at elevated risk, and need
to pay more attention to symptoms and effective lab tests
(which the standard TSH is not, nor, usually, is any
diagnosis of "normal" based on it).
Supplementation is usually simple (kelp), and
exceeding RDA needs to be considered. But any
supplementation requires first ruling out
contraindicating conditions, such as Hashimoto’s
Thyroiditis, in which iodine supplementation can be a hazard.
[⇱ Return to Nutrients List]
Hazards include anemia, with symptom indications including
but not limited to
fatigue, dizziness, hair loss, twitches,
irritability,
RLS.
Iron deficiency is by no means limited to vegetarians, either;
they are just at higher risk.
Plants often contain ample iron, but bioavailability from
plant sources is the concern,
compared to heme iron (from meat). Absorption from
plant sources may be further inhibited by other foods.
Effective supplements are easy to find, but take Iron well
away from any other supplements.[⇱ Return to Nutrients List]
Deficiencies have not been fully tallied yet, but likely include
cardiovascular disease and heart rhythm disturbances,
various
neurological
problems
(depression, ASD),
autoimmune inflammatory conditions (RA, lupus),
cancers and asthma.
This is another problem for everyone, but more acute for
vegetarians. Unless one is surf zoner chowing down on fish,
or an inland hunter-gatherer consuming game snout to tail,
one is not getting enough of these fatty acids.
The program recommendation is 3000—3600 mg per day.
This is substantially above RDA. Vegetarians are unlikely
to achieve an RBC
Omega 3 Index of even 3% without supplements,
and 10% may be optimal.
Omega 3 ALA, widely available from plant sources,
is an inadequate substitute
(and without specific attention, may itself be deficient
in a vegetarian diet). Yes, we can convert
a few percent of it to DHA and EPA, but not enough, without getting an
overload of ALA. Also, when considering any pro-vegetarian
discussion on this, pay attention to the daily intake or
synthesis of DHA suggested. If you are going to rely on ALA
(to DHA) conversion to any degree, ⎆be
sure to get ample curcumin.
Omega 6 and 9 are no substitutes at all,
and high intake of Omega 6 ⎆further
degrades ALA conversion. High intake of Omega 6
LA (Linoleic Acid) is a flat out hazard. This
PUFA
is pervasive in modern food-like substances, thanks to
the rise in industrial grain and seed oils,
mistakenly promoted as healthy. They are ⎆obesogenic,
inflammatory, and probably both trigger cancer and ⎆feed it.
The only non-animal source for DHA & EPA
is marine algae (and maybe yeast, but check the DHA/EPA balance, and last
I looked, that product was off the market).
Vegetarian DHA or EPA is quite likely from these sources. Aside -
low-fat high-carb (LFHC) vegetarian is almost certainly going to
be seriously deficient in DHA and EPA, and may quite literally
be an insane thing to do. Getting down near a 1:1 ratio of ω6:ω3,
with ample DHA & EPA in the ω3,
is tough for any modern. It’s harder for vegetarians.
[⇱ Return to Nutrients List]
Deficiency hazards include infertility in men
and women, muscle weakness, fatigue, mental fog,
hair loss, weakened immune system.
This is a regional risk planet-wide, but is more acute
in some, for vegetarians. ConsumerLab reported
“Inadequate selenium intake is of particular
concern among vegetarians and vegans in the U.K.,
where meat and dairy are the main sources of selenium.
In fact, researchers have noted that ‘⎆the
most pronounced difference in nutritional status
between British and American vegetarians is
selenium status.’ (Gibbs, Dietetics 2024)”
Supplementing can be fairly simple. One brazilnut a day might
suffice. Specific Se supplements are available and inexpensive.
Mind the TuL. More than 200µg/day is discouraged.
Se toxicity is a thing.
[⇱ Return to Nutrients List]
Deficiency hazards include vision loss, muscle atrophy,
reduced endurance,
anxiety,
depression,
ASD,
gout, hypothyroid and more. It’s pretty critical stuff,
but easily obtained in adequate amounts from meat, fish and eggs.
Vegetarian sources include brewer’s yeast.
Taurine can be synthesized industrially,
but is then at high risk of being sourced from China. Some trendy sports
drinks include mass quantities of taurine, but getting it that
way is at risk of needless sugar or artificial sweetener exposure
(in addition to the question of where the taurine came from).
[⇱ Return to Nutrients List]
Deficiency hazards include night blindness, complete blindness,
and compromised immune function.
What’s needed is a supplement, in the
retinol form. RDA suffices. The plant
form is beta-carotene, which is inefficiently converted (it would
be a lot of carrots or kale). ⎆Denise
Minger reports that about
45% of the population has BCMO1 polymorphisms that result in
even lower response to beta carotene.
[⇱ Return to Nutrients List]
Undoctored page 297 (Chapter 12): Hazards include anemias,
neurologies,
psychiatric
disorders
(including
mania
and
psychosis),
learning
impairment,
cognition
impairment,
weakness, fatigue.
Grain eaters may additionally be deficient due
to absorption impairment from grain proteins,
which interference subsides when the grains are gone.
Vegetarians usually need to supplement, and not rely
on pseudovitamin B12 sources (which not only fail to provide B12, they
actively interfere with absorption of any real B12 consumed).
Undoctored page 298 (Chapter 12) has dosing details,
which are well above RDA for everyone, not just vegetarians.
The methylcobalamin form is preferred, unless
you have had your methylation status assessed,
and know that the more common synthetic
cyanocobalamin form is safe and effective for you.
[⇱ Return to Nutrients List]
Deficiency hazards include but are not limited to
inflammation,
a variety of bone pathologies,
higher blood sugar and insulin resistance,
elevated cancer risk,
elevated risk of heart attack,
cognition,
depression,
SAD, and
autoimmune conditions.
Undoctored starting page 272 (Chapter 12):
This is a major deficiency for everyone, and Undoctored
recommends a target serum 25-hydroxyvitamin D
level of 60 to 70 ng/dl. This implies an intake well
above RDA, as a supplement (D3, cholecalciferol)
for people who
aren’t young,
aren’t exposed to substantial lower latitude sun and
aren’t getting it from animal sources.
Response to serum level is a U-shaped curve.
Both deficiency and overdose need to be avoided.
Vitamin D3 supplements are available for vegetarians,
sourced from lichen (⎆example).
Claims that plant-sourced D2 (found in certain mushrooms) is a
suitable substitute require some homework by the reader.
[⇱ Return to Nutrients List]
Deficiency hazards include fragile bones and arterial plaques.
Even meat eaters may need to supplement MK-4 or MK-7.
See Undoctored page 344 (Appendix A).
How could a vegetarian marathoner die of a sudden heart attack?
This is how (plus the usually high net carb aspect of the diet).
For vegetarians, natto is a great source of K2.
So hold your nose, or supplement. Yes, K1
is plentiful in plants, and your microbiome
⎆might
convert some of it to K2, but very likely not enough.[⇱ Return to Nutrients List]
Deficiency hazards include but are not limited to
skin and hair ailments,
oral ailments,
sensory disturbances,
intestinal distress,
poor wound healing and infection resistance,
anorexia,
cognitive
and
psychological
disorders.
Zn absorption from plant sources is the main challenge,
due to anti-nutrients.
Supplementing is relatively simple (Undoctored
page 296, Chapter 12), but attend to copper at higher doses.
[⇱ Return to Nutrients List]
⟲ Reconsiderations
As I see it, there are six broad reasons,
with one or more applying to any individual,
of why people adopt one of the vegetarian dietary approaches:
- Allergics
These people have an actual biologic adverse response
to dairy (common) or meat (uncommon, but ⎆get
some alpha-gal from a lone star tick bite,
and it could happen to anyone). In addition to needing
information on missing micronutrients, those biologically
allergic only to dairy need to know that the
allergy might vanish by switching to beta casein A2
bovine dairy, or caprine (goat) or ovine (sheep) dairy,
or simply after many months off gut antagonists in the
diet, like wheat. Even the meat allergy might eventually
vanish, once the gut has healed from grain protein and
lectin insults, and the antibody titer has receded.
- Epicureans
These people simply cannot abide the taste of meat
and/or fish. They may otherwise be open to consuming
the missing micros as supplements, even if animal-sourced.
- Environmentals
These folks think that the big problem with meat eating
is that it’s environmentally unsustainable, and that’s
true, but only if one falls for a false dichotomy, and
assumes that CAFO, supported by industrial
scale grain growing, is the only answer. The alternative,
phased pastured, as done by ⎆Joel Salatin and others,
actually solves multiple problems and is sustainable:
• eliminates CAFO and its problems
• turns grainland into grassland
• reverses desertification
• reverses micronutrient depletion
• supports consumable critters
- Theoreticals
These folks think vegetarian is an ideal or ancestral human diet.
It isn’t, and it wasn’t, except possibly for some obscure
isolated tribes [genotypes]). The odds of any reader here
being such a genotype: about 0. Even when it might have
been an ancestral diet, that doesn’t necessarily mean it
was ideal (as in living much beyond twice reproductive age).
They may have adapted to it because they had no choice.
Theoreticals are often open to information that counters
what they think they know. The work of ⎆Denise Minger
is a place to start.
- Ethicals
These people may be horrified by CAFO, resent being descended
from predators, or have other reasons why they don’t wish
to be involved in harvesting animals. On CAFO, they have a point (several
actually: conditions, antibiotics, hormones, adverse industrial feed, reduced
nutritional value, diseases, concentrated waste, etc.). Ethicals may only need to be
plugged into regional sources of humane pasture-raised
organic meats, but in any event they need to be aware
of the health trade-off they are making,
and how to counter it.
- Philosophicals
For these people, the big V is either a secular
religion or a tenet of an actual religion. The
actual health consequences are immaterial. Only the dogma
matters, although out of respect for dogs, they may prefer
it be called orthodoxy.
[⇱ Return to Top]
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Bob Niland [⎆disclosures] [⎆topics] [⎆abbreviations]